Factors associated with the death of healthcare workers due to COVID-19 in the state of Amapá, Brazil.

Introduction: Frontline healthcare workers providing care for COVID-19 are more likely to get infected and die compared with other professionals. Deaths or sick leaves due to COVID-19 can affect the smooth operation of health services in areas with shortage of workers. Objectives: To analyze factors associated with the death of healthcare workers due to COVID-19 in the state of Amapá, Brazil. Methods: Analytical cross-sectional study using COVID-19 data from Amapá between March 2020 and January 2021. The association of independent variables (sex, race/color, age group, region of residence, comorbidity) with death was analyzed by logistic regression. Results: Data from 1,258 workers were analyzed. The majority were women (67.7%; 852/1,258), multiracial (66.9%; 759/1,135), aged between 18 and 64 (98.3%; 1,226/1,247), with no comorbidity (86.6%; 1,090/1,258), from the Macapá metropolitan area (56.7%; 713/1,258). The mortality rate was 1.59%. Factors associated with death were: age group = 65 years (odds ratio = 10.43; 95% confidence interval [CI] = 2.78-39.11), comorbidity (odds ratio = 4.52; 95%CI = 1.74-11.74), and residence in the Macapá metropolitan area (odds ratio = 4.37; 95%CI = 1.25-15.29). Conclusions: The recognition of factors that may have caused the death of healthcare workers in Amapá can support the recommendation of protective measures for the most susceptible, such as switching to activities with lower exposure to the virus or teleworking.

COVID-19 in healthcare workers in the state of Espírito Santo, Brazil: clinical and sociodemographic characteristics associated with death and hospitalization.

OBJECTIVE: To analyze clinical and sociodemographic characteristics associated with death and hospitalization of healthcare workers due to COVID-19, in addition to calculating the incidence rates per profession. METHODS: A cross-sectional observational study using secondary open data from the State Health Department of Espírito Santo (ES), Brazil. The cases of COVID-19 in healthcare workers were recorded between February 27 and August 17, 2020, in Espírito Santo, excluding cases with missing information. RESULTS: Of the confirmed cases, 75.6% (n=9,191) were female. The overall case fatality rate was 0.27% and the general hospitalization rate was 0.99%. The clinical outcome of death and the occurrence of hospitalization were associated with male sex, age ≥50 years, higher education, fever, difficulty breathing, cough, cardiac comorbidity, diabetes and obesity (p<0.05). Only the occurrence of hospitalization was associated with case reported in the metropolitan region of Vitória, runny nose, sore throat, headache and renal comorbidity (p<0.05). The profession with the highest incidence rate was nurse (16,053.2 cases/100,000 nurses). CONCLUSION: The study demonstrated high frequency of cases among women, low overall case fatality rate, and high incidence in nurses.

COVID-19 in healthcare workers in the state of Espírito Santo, Brazil: clinical and sociodemographic characteristics associated with death and hospitalization

ABSTRACT Objective To analyze clinical and sociodemographic characteristics associated with death and hospitalization of healthcare workers due to COVID-19, in addition to calculating the incidence rates per profession. Methods A cross-sectional observational study using secondary open data from the State Health Department of Espírito Santo (ES), Brazil. The cases of COVID-19 in healthcare workers were recorded between February 27 and August 17, 2020, in Espírito Santo, excluding cases with missing information. Results Of the confirmed cases, 75.6% (n=9,191) were female. The overall case fatality rate was 0.27% and the general hospitalization rate was 0.99%. The clinical outcome of death and the occurrence of hospitalization were associated with male sex, age ≥50 years, higher education, fever, difficulty breathing, cough, cardiac comorbidity, diabetes and obesity (p<0.05). Only the occurrence of hospitalization was associated with case reported in the metropolitan region of Vitória, runny nose, sore throat, headache and renal comorbidity (p<0.05). The profession with the highest incidence rate was nurse (16,053.2 cases/100,000 nurses). Conclusion The study demonstrated high frequency of cases among women, low overall case fatality rate, and high incidence in nurses.

Taxas de mortalidade geral indígena nas unidades federativas do Brasil e sua (não) correlação com indicadores socioeconômicos e de saúde nos anos de 2000 e 2010 / All-cause mortality rates for indigenous in the states of Brazil and their (non) correlation with socioeconomic and health indicators in the years 2000 and 2010

Em 2010, a população indígena representava 0,2% da população brasileira e estava localizada, em maior parte, na Amazônia Legal. No Brasil, existem leis de proteção à população indígena, além de uma Política Nacional de Atenção à Saúde dos Povos Indígenas. Entretanto, grande parte da população indígena encontra-se em vulnerabilidade social e sanitária, que são mais acentuadas em determinadas regiões do país. Diante disso, este estudo objetivou calcular e avaliar a taxa de mortalidade geral na população indígena brasileira e investigar correlações com indicadores socioeconômicos e de saúde. Trata-se de um estudo ecológico baseado em dados oficiais (2000 e 2010). Os quantitativos de óbitos foram extraídos do Sistema de Informações sobre Mortalidade. Os dados de população indígena foram extraídos de Censos Demográficos do Instituto Brasileiro de Geografia e Estatística. As taxas de mortalidade geral foram calculadas por unidade federativa e correlacionadas, por meio do teste de correlação de Pearson, com indicadores socioeconômicos e de saúde extraídos da plataforma Atlas Brasil. Observou-se, no Brasil, aumento da taxa de mortalidade geral indígena de 15,0% entre 2000 e 2010. Entre as regiões, o Centro-Oeste apresentou as maiores taxas em 2000 e 2010 (4,54 e 5,56 óbitos/1.000 indígenas, respectivamente). Em 2000, o estado com maior mortalidade geral foi o Piauí (9,76/1.000) e em 2010 foi o Mato Grosso do Sul (6,54/1.000). A mortalidade geral indígena não apresentou correlação significativa (p-valor≤0,05) com os indicadores analisados. Os achados deste estudo indicaram que a taxa de mortalidade geral indígena no Brasil aumentou de uma forma desigual, de acordo com regiões/unidades federativas, e sem correlação com os indicadores socioeconômicos e de saúde analisados.

In 2010, the indigenous population represented 0.2% of the Brazilian population and was mostly located in the Legal Amazon region. In Brazil, there are laws to protect the indigenous population, in addition to a National Health Care Policy for Indigenous Peoples. However, a large part of the indigenous population is considered under social and sanitary vulnerability, which are more pronounced in certain regions of the country. Therefore, this study aimed to calculate and evaluate the all-cause mortality rate in the Brazilian indigenous population and investigate correlations with socioeconomic and health indicators. This is an ecological study based on official data (2000 and 2010). The number of deaths were extracted from the Mortality Information System. Indigenous population data were extracted from Demographic Censuses of the Brazilian Institute of Geography and Statistics. The all-cause mortality rate were calculated by states and correlated, through Pearson's correlation test, with socioeconomic and health indicators extracted from the Atlas Brazil platform. In Brazil, an increase in the overall indigenous mortality rate was observed of 15.0% between 2000 and 2010. Among the regions, the Midwest had the highest rates in 2000 and 2010 (4.54 and 5.56 deaths/1,000 indigenous people, respectively). In 2000, the state with the highest all-cause mortality rate was Piauí (9.76/1,000) and in 2010 it was Mato Grosso do Sul (6.54/1,000). All-cause mortality rate did not present a significant correlation (p-value ≤0.05) with the analyzed indicators. The findings of this study indicated that the all-cause mortality rate in Brazil increased unevenly, according to regions/states, and without any correlation with the socioeconomic and health indicators analyzed.

Epidemiological profile, occupational accidents, and socioeconomic characteristics of workers in the state of Amapá, Brazil: a time series analysis (2007-2017).

INTRODUCTION: The state of Amapá is located in Brazil's Legal Amazon and comprises 16 municipalities. Its history is marked by social vulnerability and industrial mining; therefore, its current socioeconomic and occupational context should be analyzed considering possible sociohistorical and geographic influences. OBJECTIVES: To analyze and/or describe the epidemiological profile of workers, occupational accidents, the socioeconomic context, and time evolution of the number of workers in the state and their relationship with the state's gross domestic product. METHODS: This is an analytic time series study based on official public data. We used a simple regression test to analyze the relationship between the number of workers and gross domestic product and to assess the time trend of the number of workers. The studied period was from 2007 to 2017. RESULTS: The number of workers presented an increasing trend over time (R2 = 0.902; p < 0.001), with a relative increase of 49.8% between 2007 and 2017. We observed a positive relationship between the annual increase in the number of workers and the state's gross domestic product (R2 = 0.899; p < 0.001). The economic activity with the highest mean number of workers was public administration, defense, and social security. The highest socioeconomic indicators were observed in the state capital Macapá. Non-hazardous waste management was the activity concentrating the highest absolute number of occupational accidents. CONCLUSIONS: This study highlighted important socioeconomic contrasts within the state. The significant increases in the gross domestic product and number of workers are signs of development, but the high number of occupational accidents represents a serious public health problem.

Mortalidade por suicídio: um estudo comparativo do Amapá com a região Norte do Brasil (2008-2017) / Mortality by suicide: a comparative study of Amapá with theNorthern region of Brazil (2008-2017)

Este estudo objetivou comparar as taxas de mortalidade por suicídio na região Norte e no Amapá, além de traçar tendências temporais da mortalidade para os sete estados e a região, ao longo da série temporal de 2008 a 2017. Trata-se de um estudo retrospectivo de série temporal (2008-2017). Os dados de suicídio registrados nos estados da região Norte foram extraídos dos Anuários Brasileiros de Segurança Pública. Já a fonte de dados de população, utilizados para os cálculos de mortalidade (×100.000), foi o IBGE. Para extrair a tendência das séries foram empregadas regressões simples temporais. Utilizou-se o software SPSS 20.0. No período foram registrados 4.438 suicídios na região Norte, sendo 172 (3,88%) no Amapá. Não houve diferença significativa entre as médias de mortalidade por suicídio no Amapá (x=2,65±1,12) e na região Norte (x=2,66±0,72), todavia é necessário considerar a influência da subnotificação na série temporal do Amapá. As regressões temporais demonstraram tendência crescente significativa da taxa de mortalidade por suicídio na região Norte (R2=0,566; p=0,012), no Pará (R2=0,606; p<0,01) e no Amazonas (R2=0,729; p<0,01). Esse crescimento pode estar, em parte, relacionado a fatores socioeconômicos, ao aumento da vulnerabilidade de grupos populacionais de risco e a melhoria dos serviços/sistemas de informação em saúde ocorrida nos últimos anos no Brasil. Dessa forma, os resultados evidenciaram aumento da mortalidade por suicídio na região Norte e em dois de seus estados (os dois mais populosos). Isso indica que as políticas de prevenção precisam ser reforçadas, com atenção especial as populações mais vulneráveis da região, como os indígenas.

This study aimed to compare suicide mortality rates in the Northern region of Brazil and in Amapá, in addition to plotting temporal trends in mortality for the seven states and the region, during the period from 2008 to 2017. This is a retrospective time-series study (2008-2017). Suicide data recorded in the states of the Northern region were extracted from the Brazilian Public Security Yearbook. The source of population data, used for mortality calculations (×100,000), was the IBGE. To extract the trend of the series, simple temporal regressions were used. The SPSS 20.0 software was used. During the period examined 4,438 suicides were registered in the Northern region, of which 172 (3.88%) were in Amapá. There was no significant difference between the means of suicide mortality in Amapá (x=2.65±1.12) and that in the Northern region (x=2.66±0.72). However, it is necessary to consider the influence of underreporting in the time-series analysis of Amapá. The temporal regressions showed a significant upward trend in the suicide mortality rate in the Northern region (R2=0.566; p=0.012), in the state of Pará (R2=0.606; p<0.01), and in the state of Amazonas (R2=0.729; p<0.01). This growth may be, in part, related to socioeconomic factors, the increased vulnerability of population groups at risk and the improvement of health information services/systems that have taken place in recent years in Brazil. Thus, the results showed an increase in mortality from suicide in the Northern region and in two of its two most populous states. This indicates that prevention policies need to be strengthened, with special attention to the region's most vulnerable populations, such as indigenous peoples.

Tendência na incidência de acidentes de trajeto em trabalhadores no Brasil entre 2009 e 2016 / Trend in the incidence of commuting accidents among workers in Brazil between 2009 and 2016

Introdução: Os acidentes de trajeto ocorrem no percurso do domicílio até o local de trabalho e vice-versa. Esse tipo de acidente de trabalho pode resultar em grave desordem à saúde do trabalhador e, em grande quantidade, impactar financeiramente o Sistema Único de Saúde e a Previdência Social Brasileira (PSB). Objetivos: Descrever o perfil epidemiológico e estimar a incidência dos acidentes de trajeto em trabalhadores no Brasil entre 2009 e 2016. Métodos: Estudo retrospectivo descritivo, com análises de séries temporais (2009­2016), baseado em dados secundários e oficiais extraídos dos Anuários Estatísticos da Previdência Social. As informações de População Economicamente Ativa foram retiradas da Pesquisa Nacional por Amostra de Domicílios. As incidências anuais foram calculadas para cada 100 mil pessoas economicamente ativas, independentemente de sexo, de idade e de contribuição para a PSB. Utilizou-se o Statistical Package for the Social Sciences (SPSS) para realizar testes de regressão linear simples temporal, considerando significância de p<0,05. Resultados: O perfil epidemiológico do trabalhador acometido foi de homem entre 20 e 29 anos com fratura de perna e/ou tornozelo, que representou 24,73% do total de trabalhadores acometidos. No período, a incidência dos acidentes de trajeto aumentou de 88,17 para 105,88, o que resultou em taxa de variação de 20,08% (R2 =0,715; p=0,008). Conclusão: O crescimento da incidência e do número de acidentes demonstra grande necessidade de elaboração de planos governamentais de prevenção, que devem ser direcionados aos principais grupos de risco.

Background: Commuting accidents might have serious consequences for the health of workers, in addition to considerable financial impacts on the national health system and the social security administration. Objective: To describe the epidemiological profile and calculate the incidence of commuting accidents in Brazil in the period from 2009 to 2016. Methods: Retrospective and descriptive study with time series analysis (2009­2016) based on official secondary data obtained from Social Security Statistical Yearbooks. Information on the economically active population was retrieved from the National Household Sample Survey. Annual incidence rates were calculated per 100,000 economically active population. Simple temporal linear regression analysis was performed with software Statistical Package for the Social Sciences. The significance level was set to p<0.05. Results: The epidemiological profile of workers involved in commuting accidents corresponded to men, aged 20 to 29 and with leg/ankle fractures, which represented 24.78% of the total population of involved workers. The incidence of commuting accidents increased from 88.17 to 105.88 in the analyzed period, which represents an variation rate of 20.08% (R2 =0.715; p=0.008). Conclusion: The detected rise in the incidence and number of commuting accidents point to the need for the government to formulate prevention plans targeting high-risk groups.

Trend in the incidence of commuting accidents among workers in Brazil between 2009 and 2016.

BACKGROUND: Commuting accidents might have serious consequences for the health of workers, in addition to considerable financial impacts on the national health system and the social security administration. OBJECTIVE: To describe the epidemiological profile and calculate the incidence of commuting accidents in Brazil in the period from 2009 to 2016. METHODS: Retrospective and descriptive study with time series analysis (2009-2016) based on official secondary data obtained from Social Security Statistical Yearbooks. Information on the economically active population was retrieved from the National Household Sample Survey. Annual incidence rates were calculated per 100,000 economically active population. Simple temporal linear regression analysis was performed with software Statistical Package for the Social Sciences. The significance level was set to p<0.05. RESULTS: The epidemiological profile of workers involved in commuting accidents corresponded to men, aged 20 to 29 and with leg/ankle fractures, which represented 24.78% of the total population of involved workers. The incidence of commuting accidents increased from 88.17 to 105.88 in the analyzed period, which represents an variation rate of 20.08% (R2=0.715; p=0.008). CONCLUSION: The detected rise in the incidence and number of commuting accidents point to the need for the government to formulate prevention plans targeting high-risk groups.

INTRODUÇÃO: Os acidentes de trajeto ocorrem no percurso do domicílio até o local de trabalho e vice-versa. Esse tipo de acidente de trabalho pode resultar em grave desordem à saúde do trabalhador e, em grande quantidade, impactar financeiramente o Sistema Único de Saúde e a Previdência Social Brasileira (PSB). OBJETIVOS: Descrever o perfil epidemiológico e estimar a incidência dos acidentes de trajeto em trabalhadores no Brasil entre 2009 e 2016. MÉTODOS: Estudo retrospectivo descritivo, com análises de séries temporais (2009-2016), baseado em dados secundários e oficiais extraídos dos Anuários Estatísticos da Previdência Social. As informações de População Economicamente Ativa foram retiradas da Pesquisa Nacional por Amostra de Domicílios. As incidências anuais foram calculadas para cada 100 mil pessoas economicamente ativas, independentemente de sexo, de idade e de contribuição para a PSB. Utilizou-se o Statistical Package for the Social Sciences (SPSS) para realizar testes de regressão linear simples temporal, considerando significância de p<0,05. RESULTADOS: O perfil epidemiológico do trabalhador acometido foi de homem entre 20 e 29 anos com fratura de perna e/ou tornozelo, que representou 24,73% do total de trabalhadores acometidos. No período, a incidência dos acidentes de trajeto aumentou de 88,17 para 105,88, o que resultou em taxa de variação de 20,08% (R2=0,715; p=0,008). CONCLUSÃO: O crescimento da incidência e do número de acidentes demonstra grande necessidade de elaboração de planos governamentais de prevenção, que devem ser direcionados aos principais grupos de risco.

[Neuropsychiatry and creativity: "Starry night" of Van Gogh]. / Neuropsiquiatría y creatividad: «La noche estrellada¼ de Van Gogh.

The life of Vincent van Gogh (1853-1890) has been studied thoroughly by humanists and scientists alike. His biography is an archetype of the relationship between creativity and disease. In 1956, Henri Gastaut defined his diagnosis as temporal lobe epilepsy. The artist was known for an eccentric personality and unpredictable mood, with recurrent psychotic bouts through the last two years of his life. Several authors have considered the possibility that van Gogh also suffered from bipolar affective disorder. We conducted a biographical and epistolary review with the objective of analyzing the complexity of his disease and the effects it had on his art, which ultimately placed him as one of the greatest geniuses in art.

Exposición ocupacional al calor en una empresa refinadora de metales / Occupational heat exposure in a metal industry

El estudio va dirigido a evaluar algunos indicadores ambientales y biológicos de un grupo de trabajadores expuestos a calor ambiental en razón de la actividad laboral que desempeñan. En ellos, se determina la carga calórica, gasto energético, temperatura corporal y la energía disponible de los trabajadores para realizar su trabajo. Mediante un procedimiento observacional y analítico se evaluaron en relación a las normas habituales establecidas para dichos efectos 2 puestos de trabajo, y en base a ellos se exponen los procedimientos utilizados, los resultados obtenidos y los alcances que los autores estiman de importancia desde un punto de vista ergonómico